advantages and disadvantages of Medicare Advantage plans

What are the advantages and disadvantages of Medicare Advantage plans?

Medicare can give Americans that are turning 65 much-needed health coverage. But dealing with different parts of Medicare can be overwhelming. Those who want to simplify their health coverage may consider signing up for Medicare Advantage, also known as Medicare Part C.

Medicare Advantage (MA) makes it possible for people with Original Medicare to receive their Medicare benefits and more in an alternative way. MA Plans are provided by private insurance firms contracted with Medicare to offer at least the same level of benefits provided by Original Medicare. 

To learn more if an MA Plan is right for you, let’s look at the advantages and disadvantages of Medicare Advantage Plans.

Advantages of Medicare Advantage Plans

  • Prescription Drug Coverage: Many Medicare Part C plans provide prescription drug coverage, in addition to several supplemental benefits. You are required by Medicare to have some kind of prescription drug coverage, and through a MA plan, you can get a prescription drug plan.
  • Additional Coverage: It is a must for a MA plan to provide at least the same level of coverage offered by Original Medicare. However, most of the MA plans also provide added benefits. The plans may include coverage for dental care, hearing care, meal benefits, fitness, in-home support, vision care, and transportation assistance.
  • Out-Of-Pocket Spending Limits: Medicare Part C has an out-of-pocket spending limit, which is a yearly cap on the amount you’ll pay in out-of-pocket expenses. So, once you have spent the maximum, you won’t have to pay for any Medicare-covered services for the rest of the calendar year.
  • Coordinated Care: Generally, Medicare Part C plans have networks of healthcare providers. For instance, HMO Medicare Advantage plans require the member to choose a Primary Care Physician (PCP) to help coordinate their care. Moreover, some of the MA plans that cover prescription drugs also offer medication therapy management.

Disadvantages of Medicare Advantage Plans

  • Supplemental Coverage Not Available: The people with Original Medicare can purchase a supplement insurance policy called Medicare Supplement. This plan helps with the reduction of out-of-pocket costs by covering copayments, coinsurances, and deductibles. However, if you have a Medicare Advantage plan, you cannot purchase a Medicare Supplement.
  • Strict Coverage Rules: Some Medicare Part C plans don’t allow its members to receive healthcare outside of the providers’ network unless it is an emergency. Other Medicare Advantage plans like the PPO allow its members to seek care outside of the network but charge higher prices for it.
  • You May Lose Your Coverage If You Move Out of the Provider Network: Some Medicare Advantage Plans are not available in every area. If you move to an area not covered by your provider, you may need to enroll in a different Medicare Advantage Plan or switch back to Original Medicare.

If you have any other questions about Medicare Advantage Plans, call Turning 65 Solutions, and speak with a licensed Medicare Insurance agent.

Turning 65 Solutions can help you plan for the future.